Active NPI
Creative Psychology, LTD.
- Clinical Psychologist
- Crystal Lake, IL
National Provider Identifier
1295758092
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- Legal business name
- CREATIVE PSYCHOLOGY, LTD.
- Practice address
- 610 N. Route 31
Suite E
Crystal Lake, IL 60012-3715 - Phone
- (815) 444-8469
- Fax
- (815) 479-1709
- NPI assigned
- Jul 25, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Linda Bedsole
- Title
- Owner
- Phone
- (815) 444-8469
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | IL | Primary |
Addresses
Primary practice location
610 N. Route 31
Suite E
Crystal Lake, IL 60012-3715
Mailing address
610 N. Route 31
Suite E
Crystal Lake, IL 60012-3715
Phone (815) 444-8469
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05632073 | Other | IL | BLUECROSS/BLUESHIELD |
National Provider Directory
National Provider DirectoryLocations
610 N State Route 31
Ste E
Crystal Lake, IL 60012
Phone (815) 444-8469
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Professional Counselor
- Crystal Lake, IL
- NPI 1033574629
-
- Clinical Psychologist
- Crystal Lake, IL
- NPI 1316195654
-
- Clinical Psychologist
- Rockford, IL
- NPI 1114076460
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1295758092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 N. ROUTE 31",
"address_2": "SUITE E",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "600123715",
"telephone_number": "815-444-8469",
"fax_number": "815-479-1709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "610 N. ROUTE 31",
"address_2": "SUITE E",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "600123715",
"telephone_number": "815-444-8469",
"fax_number": "815-479-1709"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CREATIVE PSYCHOLOGY, LTD.",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-25",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "BEDSOLE",
"authorized_official_first_name": "LINDA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "815-444-8469",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS/BLUESHIELD",
"identifier": "05632073",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Crystal Lake, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.